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Antihypertensive medications, bone mineral density, and fractures: a review of old cardiac drugs that provides new insights into osteoporosis

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Abstract

Osteoporosis is increasing in prevalence and importance as society’s age, with the clinical consequence of fractures of the hip, spine, and upper extremity, leading to impaired quality of life, loss of function and independence, and increased morbidity and mortality. A major risk factor for osteoporosis is older age, and cardiovascular diseases also share this risk factor; therefore, osteoporosis and cardiovascular disease often coexist and share risk factors. Medications used for the treatment of cardiovascular diseases, in particular antihypertensive drugs, have been shown in a variety of studies of varying designs to modulate bone health in both a positive or negative manner. In this article, we reviewed the pharmacology, potential mechanisms, and possible effects on bone mineral density and fracture risk of commonly prescribed antihypertensive medications, including thiazide and non-thiazide diuretics, beta-blockers, calcium channel blockers, renin–angiotensin–aldosterone system agents, and nitrates.

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Acknowledgments

No external funding source was required for this research. SRM received salary support from the Alberta Heritage Foundation for Medical Research—Alberta Innovates Health Solutions (Health Scholar), and holds the Endowed Chair in Patient Health Management (Faculties of Medicine and Dentistry and Pharmacy and Pharmaceutical Sciences, University of Alberta). The authors declare no potential conflict of interest with respect to this work.

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  1. Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada

    Mahua Ghosh & Sumit R. Majumdar

  2. 5-134B Clinical Science Building, 11350—83rd Avenue, Edmonton, AB, T6G 2G3, Canada

    Sumit R. Majumdar

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  1. Mahua Ghosh
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  2. Sumit R. Majumdar
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Correspondence to Sumit R. Majumdar.

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Ghosh, M., Majumdar, S.R. Antihypertensive medications, bone mineral density, and fractures: a review of old cardiac drugs that provides new insights into osteoporosis. Endocrine 46, 397–405 (2014). https://doi.org/10.1007/s12020-014-0167-4

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  • DOI: https://doi.org/10.1007/s12020-014-0167-4

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